Abstract

Background: Breast cancer is now the leading cancer in females. Treatment of breast cancer requires multimodalities with combination of surgery, chemotherapy, radiation and hormonotherapy and targeted therapy. The treatment is now personalized, especially in selecting chemotherapy, hormonotherapy and targeted therapy due to hormonal and Her-2 status. Hormonal receptors and her-2 status of the recurrent or metastatic lesions can be conversed in comparision with primary tumors and the new treatment should be adapted to this changes. Many studies proved this conversion and rebiopsy of recurrent or metastatic lesions was needed. However there were some studies did not reveal this finding. This problem has not been mentioned clearly in Vietnam. So we carried out this study with aims: To describe clinical and subclinical features of recurrent breast cancer and to evaluate the conversion of ER, PR and Her-2 status of the recurrent/ metastatic lesions compared to primary sites.

Subjects and methods: a descriptive retrospective cohort study on 36 breast cancer patients got curative treatment hospitalized because of recurrence or metastatic progression, from may 2015 to December 2016 at the oncology center of Hue Central Hospital, Vietnam.

Results: time to recurrence or metastatic progression was 28 months in average. Metastasis in only one organ, two organs and from 3 organs was 55.56%, 16.67%, 22.22% respectively. Most common metastatic sites were bone, axillary node, lungs, liver, supraclavicular nodes in order with rate of 50%, 41.67%, 36.11%, 27.78%, 22.22% respectively. Eleven of fourteen cases were found to have hormonal receptors and Her-2 status conversion between primary tumor and metastatic lesions. There were 4 patients with 3 discordances, 4 with 2 discordances and 3 with one discordance. Rate of hormonal receptors discordance was higher than Her-2 conversion.

Conclusion: The most common sites of recurrence and or metastases were bone, axillary adenopathies, lungs, liver, supra-clavicular adenopathies in decending order. Eleven of fourteen cases were found to have conversion of ER, PR, and Her-2 status between primary site and secondary sites which accounted for 78.57%.